Predicting the necessity of autologous blood collection and storage before surgery for hepatocellular carcinoma

Background and Objectives It remains unclear what kinds of patients undergoing hepatectomy for hepatocellular carcinoma (HCC) actually need autologous blood storage/transfusion. Methods Prior to surgery, autologous blood storage was prospectively performed in 245 patients with HCC, whereas it was not performed in 40 patients. Based on the use of the deposited autologous blood and the estimated postoperative hemoglobin (Hb) level when blood was not deposited, they were divided into necessary group and unnecessary group. By comparing the two groups, a scoring system to predict the need for autologous blood was established. Results The 245 patients from whom blood was collected and stored were categorized into necessary group (32 patients with homologous blood transfusion and 11 with estimated postoperative Hb of <8.0 g/dl) and unnecessary group (30 patients with autologous blood discarded and 172 with estimated Hb ≥8.0 g/dl). Using factors that were significantly different between the two groups, a scoring system to predict the need for autologous blood was developed; preoperative Hb level, tumor size, and tumor thrombus. The area under the receiver-operator characteristic curve of the score was 0.836. Conclusions The established scoring system was found useful in identifying those HCC patients who need autologous blood storage/transfusion during hepatectomy. J. Surg. Oncol. 2013; 108:486-491.